This invention relates to endoscopes and endoscopic surgical procedures. More particularly, this invention relates to a device and an associated method for enhancing sterility in endoscopic surgery. Even more particularly, this invention relates to a sheath member for an endoscope and an associated surgical technique.
Endoscopes are surgical instruments which enable a relatively non-intrusive visual inspection of and surgery on internal body tissues, particularly body tissues located within the digestive tract. An endoscope includes a long flexible tubular member which is inserted into the colon through the anus or into the esophagus through the mouth or the nose.
The tubular insertion member of an endoscope generally includes optical fibers for carrying light energy into the patient and for carrying organized visual information out of the patient. The insertion member also includes an elongate cylindrical channel for inserting a surgical instrument into the patient.
The operating tip of a surgical instrument which is inserted through the ancillary, biopsy, channel of an endoscope is controlled by a surgeon who manipulates an actuator at the proximal end of the endoscope. The operation is visually monitored via the visual feedback information provided by the endoscope. Larger endoscopes, particularly for use in the colon, may contain several ancillary channels, e.g., for applying suction and for feeding water and/or air to the distal end of the endoscope's insertion member.
Because endoscopes are expensive instruments, they are used on multiple patients and must accordingly be sterilized after each procedure. Sterilization generally entails soaking at least the distal end of the endoscope's insertion member in a antibacterial and antiviral solution. In addition, the operating channels of the insertion member must be flushed, preferably with a sterilizing solution.
Such sterilization procedures require substantial amounts of time. Costs are increased, not only because of the hospital personnel time involved, but also because the endoscopes are out of use for that additional time.
Moreover, there is always the risk that sterilization is inadequate and that renegade bacteria or viruses remain in the endoscope and may be subsequently transferred to a patient. This risk cannot be ignored in the present environment of AIDS and other dreaded diseases.
It is of further note that a major difficulty in performing endoscopic surgery is that the size of the endoscope's insertion member and consequently the number of instrument or operating channels therein is severely limited by the internal anatomy of the patient. The smaller passages in the gastrointestinal tract form blocks which in some cases must be forcibly dilated to enable passage of the endoscope. Such forcible entry causes trauma or pain to patient.